Radicchi Lucas Augusto, Toledo José Carlos de, Alliprandini Dário Henrique
Radiation Oncology Department, Barretos Cancer Hospital, Brazil.
Department of Production Engineering Department, Federal University of São Carlos, São Carlos, Brazil.
Rep Pract Oncol Radiother. 2020 Nov-Dec;25(6):994-1000. doi: 10.1016/j.rpor.2020.09.014. Epub 2020 Oct 3.
The aim of this study was to analyze critical success factors (CSFs) for implementation of an incident learning system (ILS) in a radiation oncology department (ROD) and evaluate the perception of the staff members along this process.
Implementing an ILS is a way to leverage learning from incidents and is a tool for improving patient safety, consisting of a cycle of reporting and analyzing events as well as taking preventive actions. ILS implementation is challenging, requiring specific resources and cultural changes.
An ILS was designed and implemented based on the CSF identified in the literature review. Before starting the ILS implementation, a structured survey was applied to assess dimensions of patient safety culture. After the period of implementation (7 months), the survey was applied again and compared with the initial assessment, and interviews were performed with staff members to evaluate the overall satisfaction with ILS and CSFs.
Statistically significant improvements were observed in 5 dimensions (12 totals) of the safety culture survey, considering time points before and after the ILS implementation. According to interviewees, "Facilitating committee", "Efficient data collection", "Focus on improvement", "Just culture" and "Feedback to users" were the most relevant CSFs.
The ILS designed and implemented at ROD was perceived as an important tool to support quality and safety initiatives, promoting the improvement in safety culture. The ILS implementation critical success factors were identified and have shown good agreement between the results of the literature and the users' practical perception.
本研究旨在分析放射肿瘤学部门(ROD)实施事件学习系统(ILS)的关键成功因素(CSF),并评估工作人员在此过程中的看法。
实施ILS是一种从事件中汲取经验教训的方法,是提高患者安全的工具,包括报告和分析事件以及采取预防措施的循环。实施ILS具有挑战性,需要特定资源和文化变革。
基于文献综述中确定的CSF设计并实施了ILS。在开始实施ILS之前,应用结构化调查来评估患者安全文化的维度。在实施期(7个月)结束后,再次进行调查并与初始评估进行比较,并与工作人员进行访谈以评估对ILS和CSF的总体满意度。
考虑到ILS实施前后的时间点,在安全文化调查的5个维度(共12个)中观察到具有统计学意义的改善。据受访者称,“促进委员会”、“高效的数据收集”、“注重改进”、“公正文化”和“向用户反馈”是最相关的CSF。
ROD设计并实施的ILS被视为支持质量和安全举措、促进安全文化改善的重要工具。确定了ILS实施的关键成功因素,并且文献结果与用户的实际看法之间显示出良好的一致性。